Urgent Advise for Entecavir Usage

I am a chronic Hepatitis B patient (29 male from Turkey) and I need your help for the medicine (Barclude 0.5mg) usage schedule and some suggestions (if you have).

Before you answer, I would like to share my story and my daily life.

I learned that I am a chronic Hepatitis B patient in last day of July 2013 after the Elisa test for the marriage (I got married in September). I was shocked because I have a fit body, eat quality foods, and I do not have any illness or discomfort.

Then I have done some test including HBV DNA. The results are;

HBSAG: 492
HBEAG: 882
ALT: 86 (it should be 15-60 for healties)
BILIRUBIN: Normal
ALBUMIN: Normal
HBV DNA: over 170 millions (could not be counted. It is may be over billions)
ULTRASOUND: TOTALLY NORMAL

Then after 2 months later I have been done biopsy. The results were not good:

FIBROSIS: stage 3
HAI: phase 11

My doctor is one of the leading professors on Hepatitis B in the world. He and his assistant started treatment with Baraclude 0.5mg (Entecavir) 2 days ago. I will buy the medicine and start taking today. My doctor told me that it does not differ that what time I take the medicine. The only important think is that I should take it everyday in the same time.

My main question is “ At what time should I take the medicine for the best results? ”. I need the suggestions of Hepatitis B patients using Baraclude.

I know it differs for everybody because everybody has different daily life routine. So, before write your answers please read below and see my daily life routine and the natural supplements for Hepatitis B.

Above you see some natural supplements (such as; black seed, turmeric, royal jelly-propolis and etc.). All the natural supplements are for Hepatitis B and I have started taking them for 3 months (after I learned I am patient). They have anti-viral effects and renewing the liver cells (I hope).

When it comes to question: “AT WHAT TIME SHOULD I TAKE BARACLUDE FOR THE BEST RESULTS?” I need the suggestions of Hepatitis B patients using Baraclude (Entecavir). And also I am very open your suggestions and sharings about Hepatitis B to get rid of this or to be more comfortable with this.

Entecavir is usually taken with an empty stomach, that is, two hours before a meal and two hours after a meal. So some patients take it before going to bed. However, this is not suitable for everyone, as some patients report that they have difficulty falling asleep.
So maybe take Entecavir two hours after breakfast or two hours after lunch?

Don't be too concerned about taking the medication at the same time, but a routine does make you remember to take it everyday.

If you are taking antiviral treatment for the first time, the empty stomach rule is not that important, according to the label information.

Entecavir is usually taken with an empty stomach, that is, two hours before a meal and two hours after a meal. So some patients take it before going to bed. However, this is not suitable for everyone, as some patients report that they have difficulty falling asleep.
So maybe take Entecavir two hours after breakfast or two hours after lunch?

Don't be too concerned about taking the medication at the same time, but a routine does make you remember to take it everyday.

If you are taking antiviral treatment for the first time, the empty stomach rule is not that important, according to the label information.

Don't be too concerned about your hbvdna numbers, they are often very very high. Just follow your doctor's instructions and be monitored by him. Your viral load should come down within a year, allowing your liver to rest and hopefully your fibrosis will reverse within a few years. No smoking, no drinking, healthy lifestyle and diet, take vitamin D if your are deficient.

Don't be too concerned about your hbvdna numbers, they are often very very high. Just follow your doctor's instructions and be monitored by him. Your viral load should come down within a year, allowing your liver to rest and hopefully your fibrosis will reverse within a few years. No smoking, no drinking, healthy lifestyle and diet, take vitamin D if your are deficient.

Yes, it is possible to reverse fibrosis, a surprise but most happy discovery. How long it takes depends on how quickly and how persistently you can reduce your viral load to undetectable. This is just my opinion.

Yes, it is possible to reverse fibrosis, a surprise but most happy discovery. How long it takes depends on how quickly and how persistently you can reduce your viral load to undetectable. This is just my opinion.

I got the new report with the medicines saying that HBV DNA is 557 million.

My HBV DNA was 840 mil before I start ETV and it went UNDETECTABLE in 14 months. I stayed on it for another 8 months before stopping. So hopefully you will do the same, albeit faster. Because during those time (I was stupid and ignorance/uneducated), I was still smoking and drinking soda/alcohol/eating junk food and unhealthy lifestyle.

I got the new report with the medicines saying that HBV DNA is 557 million.

My HBV DNA was 840 mil before I start ETV and it went UNDETECTABLE in 14 months. I stayed on it for another 8 months before stopping. So hopefully you will do the same, albeit faster. Because during those time (I was stupid and ignorance/uneducated), I was still smoking and drinking soda/alcohol/eating junk food and unhealthy lifestyle.

you are hbeag pos and very high hbvdna, entecavir is not the best choice and most potent antiviral for this status and hbvdna might take too long to become undetectable.
tenofovir is the most potent hbv drug and has over 16% hbsag clearance over 3 years use so if your liver specialist is so expert i really dont see this stupid choice of using entecavir

another very bad and annoying point on entecavir is that it is on strict surveillance for cancer since on mices it made lung cancer, it looks like it is not dangerous for human until now but there is no history on its usage over 10 years so.....
it was also a pain in the.....for the 4hrs empty stomach

i suggest to discuss tenofovir plus entecavir and then stop entecavir when hbvdna undetectable if entecavir monotherapy is not able to make hbvdna und by 6 months or if you prefer a more potent antiviral without empty stomach request

you are hbeag pos and very high hbvdna, entecavir is not the best choice and most potent antiviral for this status and hbvdna might take too long to become undetectable.
tenofovir is the most potent hbv drug and has over 16% hbsag clearance over 3 years use so if your liver specialist is so expert i really dont see this stupid choice of using entecavir

another very bad and annoying point on entecavir is that it is on strict surveillance for cancer since on mices it made lung cancer, it looks like it is not dangerous for human until now but there is no history on its usage over 10 years so.....
it was also a pain in the.....for the 4hrs empty stomach

i suggest to discuss tenofovir plus entecavir and then stop entecavir when hbvdna undetectable if entecavir monotherapy is not able to make hbvdna und by 6 months or if you prefer a more potent antiviral without empty stomach request

above all tenofovir is also cheaper and soon out of patent (this is the reason of prescrbing i beleive), generic tenofovir is about 20usd per month in india.in case you pay for the drug tenofovir is a better choice on all aspects

above all tenofovir is also cheaper and soon out of patent (this is the reason of prescrbing i beleive), generic tenofovir is about 20usd per month in india.in case you pay for the drug tenofovir is a better choice on all aspects

I would also suggest TDF. My viral load came back after I went off ETV. Probably should never be taken off it. Good luck with your treatment with ETV and I think it's probably too late for you to switch to TDF.

As with the fibrosis, the anti-viral should regress it along with healthy diet, supplements (Vit D3 a must) and no/little alcohol/junk food/soda drinks and cigarettes. Just don't do things that can hurt the liver.

I would also suggest TDF. My viral load came back after I went off ETV. Probably should never be taken off it. Good luck with your treatment with ETV and I think it's probably too late for you to switch to TDF.

As with the fibrosis, the anti-viral should regress it along with healthy diet, supplements (Vit D3 a must) and no/little alcohol/junk food/soda drinks and cigarettes. Just don't do things that can hurt the liver.

absolutely and it is also on guidelines by now that high hbvdna leads to pegintf non response, we know all the pathway by which hbv blocks intf

i think that the best approch is mine, all thanks to pisa researchers who shared some data since 2009 about avoiding peg all at once or combo peg+nucs all at once and starting by longterm sequential treatment

since we also know that nucs are necessary to recover some immunity for the add on of immune modulators it makes sense to make hbvdna und first and then try all immune modultor drugs available or vit d and gcmaf

i dont have yet my sister's results as hbsag but as an example she had no effect from gcmaf and vit d on hbvdna and alt, so according to me making hbvdna und is mandatory to expect good response from peg, gcmaf, vitd and so on

absolutely and it is also on guidelines by now that high hbvdna leads to pegintf non response, we know all the pathway by which hbv blocks intf

i think that the best approch is mine, all thanks to pisa researchers who shared some data since 2009 about avoiding peg all at once or combo peg+nucs all at once and starting by longterm sequential treatment

since we also know that nucs are necessary to recover some immunity for the add on of immune modulators it makes sense to make hbvdna und first and then try all immune modultor drugs available or vit d and gcmaf

i dont have yet my sister's results as hbsag but as an example she had no effect from gcmaf and vit d on hbvdna and alt, so according to me making hbvdna und is mandatory to expect good response from peg, gcmaf, vitd and so on

i remeber me reading somewhere thath fibroscan/bviopsy results are not accurate at all when ALT AST are so high.. high alt means liver is suffering in that moment so it can be stiff... so i would not be 100% you are F3..

i remeber me reading somewhere thath fibroscan/bviopsy results are not accurate at all when ALT AST are so high.. high alt means liver is suffering in that moment so it can be stiff... so i would not be 100% you are F3..

yes alt over 200 increase inflammation which in turn increase stiffness, there are new ways to determine correct fibroscan per abnormal alt but i d wait 3-6 months after a alt flare or simply recheck by 6 months

fibroscan is the sum of fibrosis, inflammation and when present nodules and fatty liver too, so when reading results all this must be taken into account

yes alt over 200 increase inflammation which in turn increase stiffness, there are new ways to determine correct fibroscan per abnormal alt but i d wait 3-6 months after a alt flare or simply recheck by 6 months

fibroscan is the sum of fibrosis, inflammation and when present nodules and fatty liver too, so when reading results all this must be taken into account

I just read your post and follow up by other experts. I am chronic carrier of HeB. Fortunately I had HbeAg -ve from the get go. After short 2 years on Hepsra (Adefovir), my doctor switched me to Baraclude 0.5 mg in 2007. I have been ever since on it and with very good results except my HbsAg is still reactive.
I have tried to take the Baraclude at different times but finally found best time to take for my routine is 5:30 AM to 6:00 AM every morning. This meets the requirement of 2 hours empty stomach before and after. I take breakfast after exercise and morning routine past 8:00 AM.. This gives medicine to work whole day as we are active during the day.
Hope your test results are much better by now since you are on the therapy for last 1-1/2 years. Good Luck.

I just read your post and follow up by other experts. I am chronic carrier of HeB. Fortunately I had HbeAg -ve from the get go. After short 2 years on Hepsra (Adefovir), my doctor switched me to Baraclude 0.5 mg in 2007. I have been ever since on it and with very good results except my HbsAg is still reactive.
I have tried to take the Baraclude at different times but finally found best time to take for my routine is 5:30 AM to 6:00 AM every morning. This meets the requirement of 2 hours empty stomach before and after. I take breakfast after exercise and morning routine past 8:00 AM.. This gives medicine to work whole day as we are active during the day.
Hope your test results are much better by now since you are on the therapy for last 1-1/2 years. Good Luck.

Thank you for your reply. I have read your story with keen interest and very happy with miracle cure. I like to know more about your intake of one dessert spoon of honey-royal jelly-propolis-bee pollen mix. Did you buy from health care store or from online source. I would like to know the reliable source for good quality product in USA.
I have read some negative report by a doctor and want to be careful in where to buy from.
Please help in any way you can. Thanks.

Thank you for your reply. I have read your story with keen interest and very happy with miracle cure. I like to know more about your intake of one dessert spoon of honey-royal jelly-propolis-bee pollen mix. Did you buy from health care store or from online source. I would like to know the reliable source for good quality product in USA.
I have read some negative report by a doctor and want to be careful in where to buy from.
Please help in any way you can. Thanks.

Hello, before i started treatment, my Hbv dna was 3200, after 12 weeks of entecavir Hbv dna was undetectable. I take it before i go to bed, tried to take it in the morning but felt bit dizzy during the day. It is my fifth month now, and i feel much better than before.

Hello, before i started treatment, my Hbv dna was 3200, after 12 weeks of entecavir Hbv dna was undetectable. I take it before i go to bed, tried to take it in the morning but felt bit dizzy during the day. It is my fifth month now, and i feel much better than before.

I am a chronic Hepatitis B patient (29 male from Turkey) and I need your help for the medicine (Barclude 0.5mg) usage schedule and some suggestions (if you have).

Before you answer, I would like to share my story and my daily life.

I learned that I am a chronic Hepatitis B patient in last day of July 2013 after the Elisa test for the marriage (I got married in September). I was shocked because I have a fit body, eat quality foods, and I do not have any illness or discomfort.

Then I have done some test including HBV DNA. The results are;

HBSAG: 492
HBEAG: 882
ALT: 86 (it should be 15-60 for healties)
BILIRUBIN: Normal
ALBUMIN: Normal
HBV DNA: over 170 millions (could not be counted. It is may be over billions)
ULTRASOUND: TOTALLY NORMAL

Then after 2 months later I have been done biopsy. The results were not good:

FIBROSIS: stage 3
HAI: phase 11

My doctor is one of the leading professors on Hepatitis B in the world. He and his assistant started treatment with Baraclude 0.5mg (Entecavir) 2 days ago. I will buy the medicine and start taking today. My doctor told me that it does not differ that what time I take the medicine. The only important think is that I should take it everyday in the same time.

My main question is “ At what time should I take the medicine for the best results? ”. I need the suggestions of Hepatitis B patients using Baraclude.

I know it differs for everybody because everybody has different daily life routine. So, before write your answers please read below and see my daily life routine and the natural supplements for Hepatitis B.

Above you see some natural supplements (such as; black seed, turmeric, royal jelly-propolis and etc.). All the natural supplements are for Hepatitis B and I have started taking them for 3 months (after I learned I am patient). They have anti-viral effects and renewing the liver cells (I hope).

When it comes to question: “AT WHAT TIME SHOULD I TAKE BARACLUDE FOR THE BEST RESULTS?” I need the suggestions of Hepatitis B patients using Baraclude (Entecavir). And also I am very open your suggestions and sharings about Hepatitis B to get rid of this or to be more comfortable with this.

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